Summary
Overview
Work History
Education
Skills
Accomplishments
Additional Information
Timeline
Generic

LATOYA BROWN

Southfield,MI

Summary

Experienced Medical Insurance Specialist successful at managing high caseloads in fast-paced environments. Organized, driven and adaptable with excellent planning and problem-solving abilities. Offering 7 years of experience and willingness to take on any challenge.

Overview

8
8
years of professional experience

Work History

Medical Claims Analyst

Best Buy Health
02.2021 - Current
  • Viewed reports regularly to make sure processing was conducted efficiently.
  • Maintained strict confidentiality with all personal data as per company guidelines.
  • Identified insurance coverage limitations with thorough examinations of claims documentation and related records.
  • Maintained knowledge of benefits claim processing, claims principles, medical terminology, and procedures and HIPAA regulations.
  • Managed large volume of medical claims on daily basis.
  • Researched and resolved complex medical claims issues to support timely processing.
  • Verified patient insurance coverage and benefits for medical claims.
  • Monitored and updated claims status in claims processing system.
  • Followed up on denied claims to verify timely patient payment and resolution.
  • Responded to correspondence from insurance companies.
  • Generated reports on medical claims processing activities and results.
  • Resubmitted claims after editing or denial to achieve financial targets and reduce outstanding debt.
  • Verified client information by analyzing existing evidence on file.
  • Examined claims forms and other records to determine insurance coverage.
  • Conducted day-to-day administrative tasks to maintain information files and process paperwork.

Medical Billing Specialist

Trinity Health
03.2019 - 02.2021
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Located errors and promptly refiled rejected claims.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Identified and resolved patient billing and payment issues.
  • Precisely evaluated and verified benefits and eligibility.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Printed and reviewed monthly patient aging report and solicited overdue payments.
  • Verified insurance of patients to determine eligibility.
  • Delivered timely and accurate charge submissions.
  • Prevented financial delinquencies by working closely with managers to resolve billing issues before becoming unmanageable.
  • Audited and corrected billing and posting documents for accuracy.

Accounts Receivable Specialist

Beaumont Health
05.2018 - 03.2019
  • Prepared and mailed invoices to customers, processed payments, and documented account updates.
  • Followed up overdue payments and payment plans from clients to establish good cash flow.
  • Appealed Claims for BCBS and other Commerical Payors.
  • Monitored accounts to verify compliance with payment terms and schedules.
  • Reviewed accounts on monthly basis to assess aging and pursue collection of funds.
  • Reconciled accounts receivable ledger to verify payments and resolve variances.
  • Identified, researched, and resolved billing variances to maintain system accuracy and currency.
  • Handled day-to-day accounting processes to drive financial accuracy.

Medical Billing Specialist

R1RCM
09.2016 - 05.2018
  • Communicated with insurance providers to resolve denied claims and resubmitted.
  • Located errors and promptly refiled rejected claims.
  • Examined patients' insurance coverage, deductibles, insurance carrier payments and remaining balances not covered under policies when applicable.
  • Identified and resolved patient billing and payment issues.
  • Precisely evaluated and verified benefits and eligibility.
  • Precisely completed appropriate claims paperwork, documentation and system entry.
  • Filed and updated patient information and medical records.
  • Communicated effectively and extensively with other departments to resolve claims issues.
  • Prepared billing correspondence and maintained database to organize billing information.
  • Printed and reviewed monthly patient aging report and solicited overdue payments.
  • Reviewed patient diagnosis codes to verify accuracy and completeness.
  • Delivered timely and accurate charge submissions.
  • Used data entry skills to accurately document and input statements.

Senior Patient Service Representative

Karmanos Cancer Institute
05.2015 - 09.2016
  • Provided exceptional customer service to patients, answering questions and addressing concerns.
  • Filed and maintained patient records in accordance with HIPAA regulations.
  • Verified insurance eligibility and coverage for patients.
  • Entered patient demographic and insurance data into electronic medical record system.
  • Built and maintained positive working relationships with patients and staff.
  • Managed patient registration process, confirming data accuracy and completeness.
  • Handled customer service inquiries in person, via telephone and through email.
  • Took copayments and compiled daily financial records.
  • Applied administrative knowledge and courtesy to explain procedures and services to patients.
  • Assisted patients in filling out check-in and payment paperwork.
  • Balanced deposits and credit card payments each day.
  • Resolved billing inquiries and disputes in timely fashion.
  • Developed and implemented customer service policies and procedures.
  • Answered incoming calls, scheduled appointments and filed medical records.
  • Provided excellent customer service to patients and medical staff.
  • Greeted and assisted patients with check-in procedures.
  • Facilitated communication between patients and various departments and staff.
  • Trained new staff on filing, phone etiquette and other office duties.
  • Compiled and maintained patient medical records to keep information complete and up-to-date.
  • Responded to inquiries by directing calls to appropriate personnel.

Education

Bachelor of Science - Health Administration

University of Phoenix
Tempe, AZ
06.2025

CERTIFICATE - Administrative Assistance And Secretarial Science

Everest Institute - Grand Rapids
Grand Rapids, MI
11.2009

High School Diploma -

Detroit Community High School
Detroit, MI
06.2005

Skills

  • Thorough Claims Reviews
  • Microsoft Dynamics
  • Customer Service
  • Benefits Guidelines
  • Medical Terminology
  • Electronic Claims Processing
  • Billing Software

Accomplishments

  • Documented and resolved unpaid Medicaid Claims which led to over 2.5 million in Revenue.
  • Trained new employees on successful transition to Epic Systems.
  • Successfully resolved T-file Medicare claims in multi-states which led to awards and positive revenue.

Additional Information

  • Epic Trainer
  • Trainer for Predictive Modeling for Michigan Medicaid
  • Trainer for Worker's Compensation and VA Claims billed by hand.

Timeline

Medical Claims Analyst

Best Buy Health
02.2021 - Current

Medical Billing Specialist

Trinity Health
03.2019 - 02.2021

Accounts Receivable Specialist

Beaumont Health
05.2018 - 03.2019

Medical Billing Specialist

R1RCM
09.2016 - 05.2018

Senior Patient Service Representative

Karmanos Cancer Institute
05.2015 - 09.2016

Bachelor of Science - Health Administration

University of Phoenix

CERTIFICATE - Administrative Assistance And Secretarial Science

Everest Institute - Grand Rapids

High School Diploma -

Detroit Community High School

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LATOYA BROWN